Congress Comes Back…To Look for the Exits

The day after Labor Day marked the return of members of the House of Representatives and the United States Senate to Washington for what is likely to be a minimally-productive few weeks of false starts and an early exit.

Congress has made more progress on funding legislation this year than in any recent year – but that is a very low bar to judge against. For AASLD members, however, there is encouraging news in the actual funding numbers for important programs.

Since our last column, the Senate passed the bill that includes funding for the Department of Health and Human Services’ major programs (except the Food and Drug Administration and the Indian Health Service, which are funded in two different bills). The National Institutes of Health (NIH) was the big winner in that bill, scoring a recommended $2.0 billion increase up to $39.1 billion.

Also in the Senate bill, the Agency for Healthcare Research and Quality (AHRQ) was level funded, which is a victory since the Trump administration had recommended a significant cut in funding and transferring its responsibilities to the NIH. The Division of Transplantation in the Health Resources and Services Administration is also recommended for flat funding.

Finally, one disappointing feature of the Senate bill is the lack of any significant increase for the Division of Viral Hepatitis (DVH) in the Centers for Disease Control and Prevention (CDC). Given the spike in viral hepatitis cases as a result of the opioid epidemic that is afflicting large swaths of the country, much more needs to be done in this area and AASLD, working with our patient advocate partners will need to re-double our efforts.

The House’s version of this bill is very similar with one glaring exception. NIH only receives a $1.25 billion increase in the House bill. The health research advocacy community in DC is united in encouraging the House to cede to the Senate on this issue and House members have indicated a willingness to do so.

On another front, the bill that includes funding for the Department of Veteran Affairs (DVA) Medical and Prosthetics Research program has passed both the House and Senate and is expected to be conferenced to work out differences in the bills beginning this week.

For the Medical and Prosthetics Research account, which is currently funded at $722 million, the House is recommending a modest increase to $732 million, while the Senate bill includes a more robust funding level of $779 million. Working through our coalition partners at the Friends of the VA, which is based at the Association of American Medical Colleges (AAMC), AASLD is advocating for the higher research funding level.

At the time of this writing, it appears unlikely that the HHS funding bill will be finalized prior to the end of the fiscal year on September 30, leading to the need for another Continuing Resolution (CR). The VA funding bill has a better shot of being done, but there are no guarantees on that.

Historically, a CR would be a routine step to keep the government functioning. However, the President remains a wild card in this equation as he continues to periodically suggest shutting down the government by vetoing the CR. It is unlikely the House could muster the two-thirds majority needed to override a presidential veto. We have to hope that cooler heads prevail in the White House.